Main Points

• It is recommended to include school-based sexual education in basic education programs in North Cyprus.

• Parents, teachers and school nurses should take major liability for sexual education.

• In North Cyprus, it is need to conduct many studies on sexual education.

Introduction

The World Health Organization (WHO) (1) defined “sexuality as a well-being behavior of physical, emotional, mental and social”. Sexual health is not just not having a disease, dysfunction, or disability. Sexual health requires a positive and respectful approach to sexuality and sexual relations, as well as the possibility of having pleasant and safe sexual experiences requires without forced, discrimination and violence (1). United States Council on Sexual Information and Education (SIECUS) describes “sex education as a cognitive learning and behavioral learning (communication, decision making) as a life-long process that includes biological, socio-cultural, psychological and spiritual dimensions” (2).

Sexual education is not given in the primary and secondary schools in North Cyprus. Therefore, it is considered that parents and educators have lack of education about the sexual education so the parents have major liability. This study has been prepared in order to raise awareness about the importance of sexual education, which is a neglected subject, and to contribute to the relevant literature, in the light of current studies on sexual education issues in North Cyprus. In addition, it may be raised awareness about the roles and responsibilities of nurses in sexual education for the development of sexual health.

The research methods used in the study are descriptive and documentary analysis methods. Type of the study is literature review. In the scope of the study, it was tried to include the current studies made in the last five years (2018-2023) in North Cyprus. PubMed, Google Scholar and Ulakbim databases were searched using the keywords “North Cyprus”, “Sexual Health” and “Sexual Education” and “Sexuality”.

Main Body

Sexual Education

SIECUS believes that all people have the right to receive comprehensive sexuality education. Parents are the primary sex educators of their children even though they often need to get help and encouragement. Faith-based organizations, community-based institutions and schools have an important place about this topic. Extensive school-based sexuality education should be part of the education program at all levels. These types of programs should be organized according to the age, developmental level, students’ cultural backgrounds, and the values and beliefs represented in the school. Human development, relationships, personal abilities, sexual behavior, sexual health, society and culture are the main concepts in comprehensive sexual education topics (2,3). WHO recommended that the content of sexual health education should be created according to certain age groups (4). Knowledge, skills and attitudes fragments about the age groups deepens when the age groups get older. Main topics for all age groups are the human body and its development, fertility and pregnancy, sexuality, emotions, lifestyle and relationships, sexual health and well-being, sexuality and rights are social and cultural determinants (values/norms) about sexuality (4). When the contents of both sexual education and sexual health education programs are examined, we can see that sexual education issues are multidimensional and not limited to reproduction and sexual intercourse. A healthy sexuality and sexual health can only be possible with sexual education that starts in families, continuing sexual education, and sexual health education programs in schools (5,6). There is no specific age to start sexual education despite it is the children’s curiosity about sexuality that directs parents to sexual education. Therefore, children’s asking questions about sexuality can be the starting point for parents and preschool teachers (5).

In the studies carried out that sexuality education is beneficial in preventing risky sexual behaviors by educating learners with the right knowledge and experience, that school-based sex education can reduce homophobia and homophobia-related bullying, increase understanding of gender and gender, develop knowledge and skills to support healthy relationships, and skills to prevent child sexual abuse and reduce date-partner severity (7,8). Eight sessions were prepared for preschool children aged 60-72 months focused on body parts, cleaning and care of confidential body parts, gender awareness, gender protection, gender roles, personal boundaries, how to say no, and good-bad secrets, and thereby it is thought that a sexuality education program including pre-school programs is suitable for pre-school programs in a study conducted in Turkey (9). Within the scope of a study involving Southern Cyprus, sexuality education policies in the country were examined and it was determined that the Ministry of Education did not have a specific strategy regarding sexuality education and the main obstacles were lacking teacher training and lack of funding (10).

Sexual education is not included in primary and secondary school education in North Cyprus (11). It is stated that there is the subject of “protection from abuse and threat” in the life sciences curriculum in primary and secondary education under the North Cyprus Ministry of Education (12). Since the subject of protection from sexual abuse, which is given in life sciences curriculums, is just one of the subjects of sexual education, we can see that there is a need for comprehensive sexual education in schools. In addition, we know that sexual education is not included in private schools but seminars, mainly on sexual abuse, are held in certain periods. It is stated that sexual education is not included in basic education curriculums, parents and educators are lacking in sexual education, and parents are expected to take responsibility in the pre-school period (11). Although parents are aware of the importance of sexual education at an early age, they often avoid or delay talking about sex education with their children (13). One of the biggest reasons that can be seen as a taboo in many societies talking about sexuality. If families cannot comfortably talk and respond to their children’s questions about sexuality, children may not want to receive guidance from their families on these issues. As a result, children may go towards to unreliable sources and reach inaccurate information. Since sexual education begins in the family environment, it is considered as important for parents to have information about sexual education, as well as to provide their children with communication skills about the transfer of this information (14).

Studies on the Subject in North Cyprus

When current studies on sexual education in North Cyprus are investigated, it is seen that there are very limited studies. Information on these studies is given in Table 1 in detail.

According to Table 1, when the studies reached in line with the study subject are examined; three related to child abuse (15-17), one related to sexual orientation (18), one related to gender roles (19) study were found in North Cyprus.

As a result of a study conducted with parents with children aged 8-10 in North Cyprus, it was determined that only 50% of parents could identify with the type of child abuse and suggestions were made for their children to be educated on this issue (15). In another study conducted with parents of four-six-year-old children, it was determined that parents had moderate awareness of sexual abuse and did not have sufficient knowledge (16). They found a significant connection in a study evaluating the knowledge level of parents with pre-school children aged three-six years, and their children’s attitudes towards sexual education, it was found that parents did not find themselves sufficient in providing sexual education in North Cyprus (17). In a study conducted with young adults in Famagusta district, the attitude scores of young people towards gender roles were determined to be prone to egalitarian attitudes in North Cyprus (18). In another study found, 33.3% of the participants were lesbian, 33.3% were gay, 33.3% were also found to be bisexual (19). According to the findings of same study, heterosexual individuals are generally against LGBTQ individuals and they exhibited negative attitudes and behaviors (19).

Sexual Education and Nurse

The school nurses employ primary prevention by providing health education. Sexual education is one of the health education topics. School and parents have many responsibilities to educate children with the purpose of helping them attain sexual health. However, they might also frequently need support consisting in information, motivation and strategies on sexual education. School nursing practice is student-centered, occurring within the context of the student’s family and school community. School nurses should lead parents to raise awareness about sexual education and sexual health. They can prepare education and awareness programs for teachers and parents. Also, they may prioritize the initiation and execution of comprehensive sexual education programs in pre-school and primary education. In addition, school nurses have an important and critical role in policy change with regard to sex education (6,20-22).

Conclusion

When present studies in North Cyprus are analyzed, it is seen that there are not many studies on sexual education in the country and sexual education is not given in primary and secondary education. Therefore, parents and school teachers and school nurses take major liability for sexual education. It is recommended that school-based sexual education must take part in educational program, make studies entire thesis about sexual education and give education awareness about the sexual education to both teachers and parents.

Author Contributions: Conception – Ö.A., D.S.G.; Design – Ö.A., D.S.G.; Data Collection and/or Processing – Ö.A., N.A., D.S.G.; Analysis and/or Interpretation – Ö.A., N.A., D.S.G.; Literature Review – Ö.A., N.A., D.S.G.; Writing – Ö.A., N.A., D.S.G.

Declaration of Interests: No conflict of interest was declared by the authors.

Funding: The authors declared that this study received no financial support.